Unilateral hemilaminectomy vs. laminoplasty for the resection of spinal schwannomas: an analysis of 100 patients.

Objective: Spinal schwannomas are the most common intradural extramedullary tumors, and their complete removal is recommended to avoid tumor recurrence. Although laminoplasty provides a sufficient window for tumor resection, this approach may increase tissue trauma and cause postoperative instability compared with unilateral hemilaminectomy. This study aimed to compare the efficacy and clinical outcomes of the two approaches. Materials and methods: We included 100 consecutive patients who underwent unilateral hemilaminectomy or laminoplasty for resection of spinal schwannomas between January 2015 and February 2023. The patients' baseline characteristics, including sex, age, tumor location, percentage of tumor occupying the intradural space, operative time, postoperative length of hospital stay, intraoperative bleeding volume, visual analog scale score, and neurologic results, were retrospectively analyzed. Results: Hemilaminectomy patients who underwent unilateral hemilaminectomy had smaller intraoperative bleeding (p = 0.020) volume, shorter operative time (p = 0.012), and shorter postoperative length of hospital stay (p = 0.044). The mean VAS scores at the last follow-up were similar between the two groups (p = 0.658). Although the postoperative McCormick and Karnofsky Performance scores were not significantly different between the laminoplasty and unilateral hemilaminectomy groups (p = 0.687 and p = 0.649, respectively), there was a statistically significant improvement based on postoperative neurological results compared to preoperative neurological results for both groups. The incidence of postoperative complications was 5% and 11.7% in the unilateral hemilaminectomy and laminoplasty groups, respectively (p = 0.308). Conclusions: For spinal schwannoma resection, unilateral hemilaminectomy has more advantages than laminoplasty, including a shorter postoperative hospital stay, faster procedure, and less intraoperative blood loss while achieving the same desired result.

Stroke risk with vegetarian, low-animal and high-animal diets: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVES: Vegetarian and prudent diets are associated with several health benefits but their role in stroke epidemiology is not as clear. This study aimed to evaluate stroke risk with vegetarian, low-animal, and high-animal diets. METHODS AND STUDY DESIGN: Studies reporting stroke risk with high versus low use of vegetarian or low/high-animal diets were identified by conducting literature search in Ebsco, Ovid, PubMed, Science Direct, and Web of Science databases. Relative risks (RRs) of stroke between high and low use of vegetarian, low-animal, and high-animal were pooled to achieve overall estimates. Relationship between stroke risk and increasing quantiles of dietary patterns was sought by performing metaregression analyses. RESULTS: 17 studies (932545 individuals; follow-up 11.7 years [95% confidence interval (CI): 9.5, 13.9]) were included. Compared to low use, high use of vegetarian and low-animal diets was associated with lower risk of hemorrhagic stroke (RR: 0.71 [95% CI: 0.47, 0.96] and 0.82 [95% CI: 0.64, 0.99]), ischemic stroke (RR: 0.78 [95% CI: 0.66, 0.91] and 0.70 [95% CI: 0.45, 0.95]) and total stroke (RR: 0.84 [95% CI: 0.71, 0.96] and 0.72 [95% CI: 0.61, 0.83]) respectively. Dose-response analyses further supported these findings. High use of high-animal diet was associated with relatively higher risk of stroke [RR: 1.12 [95%CI: 0.94, 1.29]. In vegetarians, relative to high use of vegetables, high use of fruits posed lower risk of stroke. CONCLUSIONS: Stroke risk is lower with more use of a vegetarian or low-animal diet but relatively higher with more use of a high-animal diet.

A Metabolic Plasticity-Based Signature for Molecular Classification and Prognosis of Lower-Grade Glioma.

BACKGROUND: Glioma is one of the major health problems worldwide. Biomarkers for predicting the prognosis of Glioma are still needed. METHODS: The transcriptome data and clinic information on Glioma were obtained from the CGGA, TCGA, GDC, and GEO databases. The immune infiltration status in the clusters was compared. The genes with differential expression were identified, and a prognostic model was developed. Several assays were used to detect RPH3A's role in Glioma cells, including CCK-8, colony formation, wound healing, and transwell migration assay. RESULTS: Lower Grade Glioma (LGG) was divided into two clusters. The immune infiltration difference was observed between the two clusters. We screened for genes that differed between the two groups. WGCNA was used to construct a co-expressed network using the DEGs, and four co-expressed modules were identified, which are blue, green, grey, and yellow modules. High-risk patients have a lower overall survival rate than low-risk patients. In addition, the risk score is associated with histological subtypes. Finally, the role of RPH3A was detected. The overexpression of RPH3A in LGG cells can significantly inhibit cell proliferation and migration and regulate EMT-regulated proteins. CONCLUSION: Our study developed a metabolic-related model for the prognosis of Glioma cells. RPH3A is a potential therapeutic target for Glioma.

Surgical Resection of Dorsal Spinal Meningiomas with the Inner Dura Layer-An Improved Preservation Technique of Spinal Dura in 40 Cases.

BACKGROUND: Spinal meningiomas are the common benign tumors in intradural extramedullary spinal tumors. Simpson grade I resection is recommended to avoid tumor recurrence. However, the dura reconstruction increases a risk of cerebrospinal fluid leakage after this surgical resection. To address this concern, the inner dura layer resection and long-term surgical outcomes of this technique were designed and examined after total tumor resection to preserve the outer dura layer. METHODS: This study included 40 spinal meningioma patients undergoing the outer dura layer resection between 2002 and 2019. Clinical characteristics, radiologic features, preoperative and postoperative functional states, tumor recurrence, and perioperative complications were described and evaluated. RESULTS: A total of 40 spinal meningioma cases with the median age of 63 years (36-81 years) were enrolled in this study. The median postoperative follow-up period of all 40 cases was 96 months (34-193 months). About 82.5% of cases were located in the thoracic spine, while 16.5% of cases were located in the cervical spine. Of the symptomatic cases, 87.5% of cases follow with satisfactory outcomes and 12.5% of cases follow with unexpected outcomes. The local spinal meningioma recurrence rate was 2.5% (1 of 40 cases). No postoperative cerebrospinal fluid leak occurred in the 40 spinal meningioma cases. CONCLUSIONS: A long-term postoperative follow-up indicated that this modified spinal dura preservation technique caused good neurologic improvement with rare recurrence. Therefore we recommend this improved technique may be an alternative surgical option for total resection of spinal meningiomas with favorable prognosis.

Gut microbial metabolite TMAO portends prognosis in acute ischemic stroke.

BACKGROUND: Over the recent years, the role of trimethylamine N-oxide (TMAO) as a gut-derived metabolite mediating cardiovascular disease pathogenesis has been under particularly intense scrutiny. The aim was to explore whether TMAO levels were associated with clinical severity or functional outcome in Chinese patients with ischemic stroke. METHODS: This is a single-center, prospective cohort study from Xiamen, China. We examined the relationship between fasting TMAO and 2 of its nutrient precursors, choline and betaine, vs. 3-month functional outcome and mortality in 351 first-ever patients with acute ischemic stroke. RESULTS: The median value of the plasma level of TMAO was 6.1 µM (IQR, 3.7-9.9 µM), which was higher than in those control cases (4.0; 2.4-5.9 µM). Patients with a poor outcome and nonsurvivors had significantly increased TMAO levels on admission (P < 0.001). Following adjustments for traditional risk factors, increased TMAO concentrations remained predictive of both poor outcome and mortality risks in stroke patients [e.g., quartiles 4 vs 1, odd ratio 5.65 (95% CI, 2.87-13.45), P < 0.001; and 5.84 (95% CI, 3.05-16.12), P < 0.001, respectively]. In multivariate analysis, TMAO was an independent predictor of functional outcome and mortality and improved the prognostic accuracy of the NIHSS to predict functional outcome (combined areas under the curve, 0.82; 95% CI 0.77-0.89, P = 0.003) and mortality (combined areas under the curve, 0.85; 95% CI: 0.80-0.90, P = 0.002). CONCLUSIONS: Fasting plasma concentrations of gut microbial TMAO are higher in patients with ischemic stroke and portend higher poor functional outcome events and mortality.

Effects of GABAB receptors in the insula on recognition memory observed with intellicage.

BACKGROUND: Insular function has gradually become a topic of intense study in cognitive research. Recognition memory is a commonly studied type of memory in memory research. GABABR has been shown to be closely related to memory formation. In the present study, we used intellicage, which is a new intelligent behavioural test system, and a bilateral drug microinjection technique to inject into the bilateral insula, to examine the relationship between GABABR and recognition memory. METHODS: Male Sprague-Dawley rats were randomly divided into control, Sham, Nacl, baclofen and CGP35348 groups. Different testing procedures were employed using intellicage to detect changes in rat recognition memory. The expression of GABABR (GB1, GB2) in the insula of rats was determined by immunofluorescence and western blotting at the protein level. In addition, the expression of GABABR (GB1, GB2) was detected by RT-PCR at the mRNA level. RESULTS: The results of the intellicage test showed that recognition memory was impaired in terms of position learning, punitive learning and punitive reversal learning by using baclofen and CGP35348. In position reversal learning, no significant differences were found in terms of cognitive memory ability between the control groups and the CGP and baclofen groups. Immunofluorescence data showed GABABR (GB1, GB2) expression in the insula, while data from RT-PCR and western blot analysis demonstrated that the relative expression of GB1 and GB2 was significantly increased in the baclofen group compared with the control groups. In the CGP35348 group, the expression of GB1 and GB2 was significantly decreased, but there was no significant difference in GB1 or GB2 expression in the control groups. CONCLUSIONS: GABABR expression in the insula plays an important role in the formation of recognition memory in rats.

Dissection of functional lncRNAs in Alzheimer's disease by construction and analysis of lncRNA-mRNA networks based on competitive endogenous RNAs.

Alzheimer's disease (AD) is a neurodegenerative disorder that is the most common cause of dementia in the elderly, and intracellular neurofibrillary tangles (NFTs) are one of the pathological features of AD. Recent studies have suggested long noncoding RNAs (lncRNAs) play important roles in AD. Competing endogenous RNAs (ceRNAs) is a mechanism that has recently been proposed, in which lncRNAs compete for common miRNA-binding sites with mRNAs. However, the roles of lncRNAs and ceRNA in AD NFTs is limited. In this study, we constructed a global triple network based on ceRNA theory, then an AD NFT lncRNA-mRNA network (NFTLMN) was generated. By analyzing the NFTLMN, three lncRNAs (AP000265.1, KB-1460A1.5 and RP11-145M9.4), which are highly related with AD NFTs were identified. To further explore the cross-talk between mRNAs and lncRNAs, a clustering module analysis was performed on the NFTLMN and two AD NFT related modules were identified. Our study provides a better understanding of the molecular basis of AD NFTs and may offer novel treatment strategies for AD.

Perihematomal pathological changes in neurons and astrocytes following acute cerebral hemorrhage.

We aim to investigate the pathological temporospatial characteristics of brain cell injury in the perihematomal areas. Brain autopsy samples from 44 consecutive cases of intracerebral hemorrhage were processed and analyzed following immunohistochemical staining for neurofilament (NF) and glial fibrillary acidic protein (GFAP). NF and GFAP positive cells were scored and graded according to the distance from the hematoma and the time from the onset of hematoma formation. The tissues from the same region on the contralateral side of the brain were used as controls. Neurons in the perihematomal areas exhibited pyknosis or swollen necrosis, while astrocytes were swollen. Morphological abnormalities pertaining to NF appearance were attenuated with increasing distance from the hematoma wall, but were exacerbated with prolonged bleeding time. The level of NF staining abnormality was positively correlated with time from the onset of hematoma within 7 days of intracerebral hemorrhage. In contrast, the intensity of GFAP staining was negatively correlated with time from the onset of hematoma formation. This immunoreactivity was significantly higher closer to hematoma. Taken together, these data indicate that pathological alterations in neurons and astrocytes in the perihematomal area change with time from the onset of hematoma formation.